DR. ROBERT TATE MARTIN (NPI# 1801886585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801886585 |
| Entity Type | Individual |
| Full Name | DR. ROBERT TATE MARTIN |
| Credential | MD |
| Practice Address |
1811 E Bert Kouns Industrial Loop # 210 Shreveport LA 71105 |
| Mailing Address |
1811 E Bert Kouns Industrial Loop # 210 Shreveport LA 71105-5740 |
| Practice Telephone | 3182123858 |
| Practice Fax Number | 3182123958 |
| Mailing Telephone | 3182123858 |
| Mailing Fax Number | 3182123958 |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2019-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD.021109 | LA | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
L#021109 | LA | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
L#021109 | LA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | RAILROAD MEDICARE | 060053256 | 01 |
| LA | 1017159 | 05 | |
| AR | 132212001 | 05 | |
| TX | 057726401 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1453 E Bert Kouns Industrial Loop, Suite 315, Shreveport, LA 711056800 | 3186815240 | 3186815241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609426030 | Robert Arthur Martin Jr. | Counselor | 15 S Grady Way Ste 241, Renton, WA 98057-3209 | 2019-09-17 |
| 1861992372 | Robert Martin | Nurse Practitioner | 4475 Willa Creek Dr Apt 111, Winter Springs, FL 32708-5227 | 2018-02-20 |
| 1972908556 | Robert Martin | Pharmacist | 19315 Mountain Meadow Ct, Grass Valley, CA 95949-9579 | 2014-10-25 |
| 1073834404 | Robert Ambrose Martin | Family Medicine | 380 S Davis Rd, Suite E&f, Lagrange, GA 30241-2588 | 2010-06-21 |
| 1275863995 | Robert Gene Martin | Social Worker | 1315 Central Ct, Hermitage, TN 37076-3153 | 2009-12-31 |
| 1932438595 | Robert Carl Martin | Chiropractor | 78-6894 Keaupuni St, Kailua Kona, HI 96740-2847 | 2009-12-10 |
| 1891966404 | Robert Andrew Martin | Dentist | 101 Walker Way, Starkville, MS 39759 | 2008-03-22 |
| 1396961728 | Robert Stephen Martin | Dentist | 2225 Defense Hwy., Suite G, Crofton, MD 21114 | 2007-04-17 |
| 1104944974 | Robert I Martin | Preventive Medicine | 1127 N North Street, Peoria, IL 61606 | 2007-03-27 |
| 1417092230 | Robert Earl Martin Jr. | Dentist | 3609 Georgia Ave Nw, Washington, DC 20010-1634 | 2007-02-20 |
| Street Address |
1811 E BERT KOUNS INDUSTRIAL LOOP # 210 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104281476 | White Clover, LLC | Internal Medicine | 8835 Line Ave Ste 400, Shreveport, LA 71106-6730 | 2015-12-30 |
| 1831331842 | Vieux Carre Investments, LLC | Internal Medicine | 8730 Youree Dr Ste B, Shreveport, LA 71115-2518 | 2009-04-06 |
| 1184720393 | Joseph L. Fredi | Internal Medicine | 1811 E Bert Kouns Industrial Loop Ste 210, Shreveport, LA 71105 | 2006-09-15 |
| 1255321881 | Michael Glen Walton | Internal Medicine | 2727 Hearne Ave, Suite 300, Shreveport, LA 71103-3917 | 2005-10-25 |
| 1760472419 | Paul Corkran Davis | Internal Medicine | 1453 E Bert Koun Loop Ste 112, Shreveport, LA 71105-6810 | 2005-10-25 |
| 1669472155 | Sanders Fowler Hearne | Internal Medicine | 1811 E Bert Kouns, Suite 100, Shreveport, LA 71115 | 2005-07-26 |
| 1588664080 | William Howard Haynie Jr. | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2005-07-26 |
| 1881127090 | Advanced Cardiovascular Specialists | Internal Medicine | 1453 E Bert Koun Loop, Ste 112, Shreveport, LA 71105-6800 | 2017-04-05 |
| 1972043511 | Wk Heart and Vascular Institute Chf Clinic | Internal Medicine | 2727 Hearne Ave, Shreveport, LA 71103-3917 | 2017-03-01 |
| 1063963189 | Basel Kasabali Md Apmc | Internal Medicine | 1800 Irving Pl, Shreveport, LA 71101-4608 | 2016-10-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on DR. ROBERT TATE MARTIN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.